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Pike C, Coakley C, Ahmed N, Lee D, Little F, Padian N, Bekker LG. Goals for girls: a cluster-randomized trial to investigate a school-based sexual health programme amongst female learners in South Africa. Health Educ Res 2023; 38:375-391. [PMID: 37405698 PMCID: PMC10516375 DOI: 10.1093/her/cyad025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 07/06/2023]
Abstract
The delivery of comprehensive sexuality education to adolescents at school is recognized as a long-term strategy to support adolescent health. Suboptimal sexual and reproductive health (SRH) outcomes among South African adolescents necessitate the ongoing development and optimization of SRH education and promotion models. We conducted a cluster-randomized controlled trial amongst secondary schools (n = 38) in Cape Town, South Africa, to evaluate a sport-based, near-peer-led SRH curriculum, SKILLZ, amongst female learners (n = 2791). Biomedical (sexually transmitted infections [STIs], human immunodeficiency virus [HIV] and pregnancy) and socio-behavioural (social support, gender norms and self-concept) outcomes were assessed pre and post intervention. Attendance at SKILLZ was low and intervention participants did not show an improvement in SRH outcomes, with HIV and pregnancy incidence remaining stable and STI prevalence remaining high and increasing in both control and intervention arms. Although evidence of positive socio-behavioural measures was present at baseline, participants with high attendance showed further improvement in positive gender norms. SKILLZ did not demonstrate the capacity to significantly impact clinical SRH outcomes. Modest improvements in outcomes amongst high attenders suggest that the impact may be possible with improved attendance; however, in the absence of optimal attendance, alternative intervention strategies may be required to improve SRH outcomes amongst adolescents.
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Affiliation(s)
- C Pike
- Desmond Tutu HIV Centre, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa
| | - C Coakley
- Desmond Tutu HIV Centre, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa
- Centre for Social Science Research, Faculty of Humanities, University of Cape Town, Cape Town 7701, South Africa
| | - N Ahmed
- Desmond Tutu HIV Centre, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa
- Mortimer Market Centre, Central North West London NHS Trust, Off Caper Street, London WC1E 6 JB, UK
| | - D Lee
- Grassroot Soccer, 35 Jamieson Street, Cape Town 7784, South Africa
| | - F Little
- Department of Statistical Sciences, University of Cape Town, Private Bag X3, Rhodes Gift, Cape Town 7707, South Africa
| | - N Padian
- Grassroot Soccer, 35 Jamieson Street, Cape Town 7784, South Africa
- School of Medicine University of California San Francisco, San Francisco, CA 94143, USA
| | - L G Bekker
- Desmond Tutu HIV Centre, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa
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Smith TA, Lehmann D, Coakley C, Spooner V, Alpers MP. Relationships between growth and acute lower-respiratory infections in children aged less than 5 y in a highland population of Papua New Guinea. Am J Clin Nutr 1991; 53:963-70. [PMID: 2008875 DOI: 10.1093/ajcn/53.4.963] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
One hundred fifty-six children in the highlands of Papua New Guinea aged less than 5 y, studied for a total of 7019 child-weeks, had an incidence of 1.3 episodes per child-year of acute lower-respiratory-tract infections (ALRIs). There was a marked age trend with an incidence of almost three times this average for children aged less than 6 mo. Those with low weight-for-age or low height-for-age had a higher ALRI incidence rate, with no evidence of cutoffs above which nutritional status had no effect; there was no association between low weight-for-height and increased risk of ALRI. A slow weight gain was not a significant risk factor in the short term but weight gain was reduced during episodes of ALRI.
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Affiliation(s)
- T A Smith
- Papua New Guinea Institute of Medical Research, Eastern Highlands Province
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Montgomery JM, Lehmann D, Smith T, Michael A, Joseph B, Lupiwa T, Coakley C, Spooner V, Best B, Riley ID. Bacterial colonization of the upper respiratory tract and its association with acute lower respiratory tract infections in Highland children of Papua New Guinea. Rev Infect Dis 1990; 12 Suppl 8:S1006-16. [PMID: 2270397 DOI: 10.1093/clinids/12.supplement_8.s1006] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Acute lower respiratory tract infection (ALRI) is the major cause of death among children in Papua New Guinea. This longitudinal study reports the bacteriologic findings for children observed in their hamlets. A total of 1,449 nasal swab specimens from 158 children less than 5 years of age who were studied intensively for 18 months were examined. Non-serotypable strains of Haemophilus influenzae were isolated from 91% of specimens, and serotypable strains were isolated from 35% (8% H. influenzae type b) of specimens. All children had acquired Streptococcus pneumoniae by the age of 3 months. The most frequently occurring serotypes of S. pneumoniae were 6, 19, and 23. Children more frequently carried invasive pneumococci during an episode of ALRI than when they were healthy. Also, children more frequently carried serotypable strains of H. influenzae during the 2 weeks preceding an episode of ALRI than when they were healthy. Between-children analyses showed that children who were susceptible to attacks of ALRI and those who were not susceptible had similar rates of carriage of bacteria.
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